Feasibility study of the Kinsey Institute Homework Intervention (KIHISUK) to promote correct and consistent condom use

有什么问题吗？在过去的10年里，英格兰的性传播感染（STIs）的发病率增加了大约50%，每年大约有50万新病例发生。性传播感染的健康、社会和经济成本是巨大的。例如，未经治疗的衣原体可导致盆腔炎和不孕症。目前，NHS每年的治疗费用估计为6.2亿英镑。卫生部已确定有必要降低性传播感染率，将其作为改善性健康的优先事项，并将年轻异性恋者视为目标“风险”群体。为什么我们需要做点什么？虽然避孕套在正确和持续使用的情况下可以预防性传播感染，但使用避孕套有许多障碍，如消极态度、性快感降低、“适合和感觉”问题以及勃起困难。不完全使用避孕套也会降低避孕套的有效性（即从性交开始到结束都没有使用避孕套），这在使用避孕套时遇到问题的男性中更为常见。许多健康促进干预措施试图提高知识和技能，以增加避孕套的使用；然而，结果喜忧参半。虽然有一些证据表明这些干预措施可能是有效的，但在实践中，健康促进工作人员可能没有时间或金钱来使用这些措施。因此，迫切需要制定快速而有效的干预措施，以改善安全套的使用体验，增加一贯和正确的安全套使用，并降低年轻人的性风险。我们要做什么？我们想把在美国开发和测试过的安全套推广项目推广给英国的年轻男性。美国的这个项目发放了“避孕套包”（包含不同的避孕套和润滑剂），要求男性通过完成各种家庭作业，自己在家试用避孕套。当他们测试每个避孕套时，他们被要求思考自己的快乐和他们最喜欢的避孕套。然后男性对他们使用的避孕套进行评分。该项目的目的是让男性通过以下方式提高他们使用避孕套的技能：1)找到“合适/最好”的避孕套和润滑剂类型；2)测试使用它们的技术；3)在没有压力的情况下（自己）练习使用它们。在这项研究中，我们想看看这个想法是否可以适用于英国的男性，以提高他们使用避孕套的技能和使用避孕套的乐趣。为此，我们将与青年男子和健康促进专业人员交谈，了解他们的意见，并帮助我们修改和发展新方案的组成部分。然后，我们将邀请汉普郡和西米德兰兹郡社区和教育机构的年轻人信息和咨询服务机构参与并帮助招募50名16-25岁的年轻人来测试该计划。衡量标准：我们想知道年轻人是否喜欢课程的不同元素，以及是否有可能在不同的环境中进行我们的研究。我们也在测试是否有可能做一个更大的试验，看看这个项目是否能改变男人对避孕套的看法和使用，并估计实施这项计划所需的成本、时间、资源、样本量、结果测量等。在节目结束时，我们会询问参与者对这项研究的看法以及我们要求他们做的事情。这项工作将增加开发有效的避孕套推广干预措施的可能性，并评估更大规模的试验是否合理和适当。

What is the problem? Rates of sexually transmitted infections (STIs) in England have increased by around 50% over the last 10 years, with about half a million new cases occurring every year. The health, social, and economic costs of STIs are huge. Untreated chlamydia, for example, can lead to pelvic inflammatory disease and infertility. The current estimated cost of treatment to the NHS is £620 million per year. The Department of Health has identified the need to reduce STI rates as a priority for improving sexual health and have recognised young heterosexuals as target 'at-risk' groups.Why do we need to do something? Although condoms can be protective against STIs when used correctly and consistently, there are many barriers to their use such as negative attitudes, reduced sexual pleasure, "fit-and-feel " problems, and erection difficulties. The effectiveness of condoms is also reduced by incomplete use of condoms (i.e. not using condoms from start to the finish of sex), which is more commonly reported by men who experience problems whilst using condoms. Many health promotion interventions try to improve knowledge and skills to increase condom use; results, however, have been mixed. Although there is some evidence that these interventions can be effective, in practice health promotion staff may not have the time or the money to use these. There is therefore an urgent need to develop quick but effective interventions to improve condom use experiences, increase consistent and correct condom use, and reduce sexual risk among young people.What are we going to do? We want to adapt a condom promotion programme which has been developed and tested in the US for use among young men in the UK. The US programme gives out "condom kits" (containing different condoms and lubricants) asks men to try out the condoms at home by themselves by completing various homework exercises. As they test each condom they are asked to think about their own pleasure and which condoms they like best. Men then score/rate the condoms they use. The aim of the programme is for men to improve their condom skills by 1) finding the "right/best" types of condoms and lubricants, 2) testing techniques of applying them, and 3) by practicing with them in no pressure situations (on their own). In this study we want to see if the idea can be adapted for use with men in the UK to improve their skills in applying condoms and their pleasure in using them. To do this we will be speaking to young men and health promotion professionals to find out their views and help us modify and develop the components of the new programme. We will then invite young people's information and advice services in community and educational establishments in Hampshire and the West Midlands to take part and help recruit 50 young men aged 16-25 to test out the programme. What we will measure: We want to know if young men like the different elements of the programme and if it is possible to run our study in the different settings. We are also testing whether it is possible to do a larger trial to see if the programme can change men's views and use of condoms, and to estimate the costs, time, resources, sample sizes, outcome measures etc. needed to carry this out. At the end of the programme we will ask participants for their views about the study and what we asked them to do. This work will increase the likelihood of developing an effective condom promotion intervention, and to assess whether a larger trial is justified and appropriate.